Progress in palliative care in Israel: comparative mapping and next steps

Abstract

Palliative care was established rapidly in some countries, while in other countries its establishment has taken a different trajectory. This paper identifies core steps in developing a medical specialty and examines those taken by Israel as compared with the US and England for palliative care. It considers the next steps Israel may take.Palliative care aims to provide quality of life for those with serious illnesses by attending to the illness-prompted physical, mental, social, and spiritual needs of patients and their families. It has ancient roots in medicine; its modern iteration began against the backdrop of new cures and life-sustaining technology which challenged conceptions of how to respect the sanctity of life.The first modern hospice was created by Saunders; it provided proof that palliative care works, and this has occurred in Israel as well (the first step). Another key step is usually skills development among clinicians; in Israel, few education and training opportunities exist so far. Specialty recognition also has not yet occurred in Israel. Service development remains limited and a major shortage of services exists, compared to the US. Research capacity in Israel is also limited. Policy to develop and sustain palliative care in Israel is underway; in 2009, the Ministry of Health established policy for implementing palliative care. However, it still lacks a financially viable infrastructure.We conclude that palliative care in Israel is emerging but has far to go. Adequate resource allocation, educational guidelines, credentialed manpower and specialty leadership are the key factors that palliative care development in Israel needs.

Quality of Care of Older People Living with Advanced Dementia in the Community in Israel

“…The current study rate was higher than 12% of home care patients reported previously and 10% reported in hospitals, nursing homes, and assisted living in the United States. Cultural, ethical, religious, and administrative considerations influence the decision to insert a feeding tube . There are no Israeli Ministry of Health guidelines regarding the use of enteral feeding in individuals with dementia in the community.…”

“…Cultural, ethical, religious, and administrative considerations influence the decision to insert a feeding tube. [36][37][38] There are no Israeli Ministry of Health guidelines regarding the use of enteral feeding in individuals with dementia in the community. In Israeli culture, the sanctity of human life is a central value, and human life is deemed of infinite value.…”

International Profiles of Health Care Systems, 2015

“…Dental care for adults, optometry, and home care are generally excluded, although the National Insurance Institute does provide some funding for home care, dependent on need. Limited palliative and hospice services are included in the NHI benefits package as well (Bentur et al, 2012).…”

Oncologists’ identification of mental health distress in cancer patients: Strategies and barriers

“…Moreover, oncologists in our study reported that, in their view, distress was a "normal" part of the cancer trajectory, akin to other symptoms of cancer treatment such as hair loss, and was part and parcel of receiving a cancer diagnosis. While distress may be one response to cancer and the treatment trajectory, there is substantial evidence that psychosocial care (Andersen et al, 2004;Breitbart et al, 2015;Carlson et al, 2012;Faller et al, 2013;Fann et al, 2012;Jacobsen & Wagner, 2012;Li et al, 2012;Stagl et al, 2015) and adequate control of physical symptoms including pain relief (Bentur, Emanuel, & Cherney, 2012;Ferrell et al, 2016;Gans et al, 2012;Temel et al, 2010;Zimmermann et al, 2014) can substantially eliminate the distress associated with cancer. Appropriate systematic screening of distress in cancer patients is essential to providing the best quality of care.…”